Ureteral motility after renal autotransplantation.

Twelve kidneys were autotransplanted to the internal iliac vessels in 11 patients for the treatment of renovascular hypertension. The ureter had been left unresected in all but one case, where a transuretero-ureterostomy was performed. A radiographic study of the ureteral motility was obtained during the postoperative period recording images every 1.5 s with a spot-camera system. The ureters appeared to follow different courses, due to the different surgical procedures. In all but two cases the transport of urine was obtained through separate boluses, frequency and direction of peristalsis were within normal ranges, and significant dilation was never observed.

Staghorn renal stones: value of bench surgery and autotransplantation.

Two patients with staghorn renal calculi underwent bench surgery and autotransplantation. A discussion is presented on the value of an extracorporeal procedure for patients with staghorn calculi associated with renal artery or pyeloureteral junction stenosis.

Vascular impressions on the renal-collecting system: diuretic cine-roentgenographic and angiographic study of 50 cases.

The vascular impressions on the renal pelvis and caliceal system may assume an important role in the study of some patients with hematuria and renal pain of unclear origin. 50 patients presenting vascular impressions on the calices and renal pelvis have been studied. In 12 patients (24%) the impressions were bilateral and in 38 (76%) unilateral: in 35 patients (70%) the right kidney was involved. In each patient the morphological pyelocaliceal variations have been studied with cine-roentgen-dynamic investigations and in 30 angiography was also performed. Interesting results have been obtained with cine-roentgenographic investigations during forced diuresis allowing differentiation between intrinsic and extrinsic lesions of the renal collecting structures, without resorting to more complex investigations such as angiography.

Blind-ending branch of bifid ureter: report of seven cases.

Seven cases of bifid ureter with a blind-ending branch are presented: diagnosis was primarily made by excretory urogram. In 1 case the diagnosis was confirmed by retrograde pyelogram. The pelvicalyceal system showed ureteroureteral reflux into the blind-ending branch on photofluoroscopy and cineroentgenography. One rare case of blind-ending branch originating in the upper third of the ureter are described. The clinical aspects, roentgenographic findings, and treatment of these findings are reviewed.

Ex situ surgery of the kidney: experience with 20 autotransplantations.

The authors propose a classification of ex situ surgery of the kidney and present their clinical experience of 20 renal autotransplantations over a period of 6 years: 16 were performed for renovascular hypertension with 2 failures and 4 for recurrent staghorn calculi, with 1 stone recurrence. Based on their experience and on the literature they discuss the present status and the future implications of ex situ surgery of the kidney.

Surgical treatment of rectourethral fistulae.

9 male patients with rectourethral fistula were treated. Fistulae were congenital in 1 case, iatrogenic in 6 cases and traumatic in 2 cases. In 8 cases we used an abdominoperineal approach with omentoplasty or peritoneal flap; in 1 case a perineal approach was made. In 2 cases it was also necessary to use a transpubic approach to the posterior urethra. Good results were obtained in all cases. The importance of a proper radiological investigation of the fistulous tract and the use of omentoplasty are both emphasized.